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HIU: They Healthhealth Should Be Part of Every Cost-Containment Strategy

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HIU: They Healthhealth Should Be Part of Every Cost-Containment Strategy

  1. 1. TELEHEALTH | HIU 49 treatment for minor conditions, resulting in lost productivity and unnecessary costs for themselves and/or their employers. As for doctors, they may be forced to rush them through their ofces in order to keep up with the increased demand. What about afer hours?We expect to see an increasing number of individuals going to urgent care clinics and ERs if they can’t get in to see a doctor, resulting in even greater costs. Te American Medical Association states that 70% of doctor’s ofce visits can be handled over the phone and 50% of ER visits are non emergencies. Telehealth’s savings in claim costs range from $300 per year for a single employee or more than $1,000 per year for a family of four.1 Te bottom line is clear:Te healthcare industry has changed and it will contin ue to become more antiquated, inefcient and costly unless there is change. It’s the perfect storm for innovative solutions. According to TowersWatson: “Over the next fve years…nearly half the employ ers expect a signifcant or transformative change. More specifcally, 49% expect more healthcare price transparency and 45% expect to see new access points for healthcare delivery, such as telemedicine, e visits and data enabled kiosks.”2 A SENSIBLE SOLUTION THAT IS AVAILABLE TODAY Te telehealth industry, as it relates to individuals and the workplace, has been in development for more than 12 years, fne tuning itself to deliver quality care when and where it’s needed. Currently, there are close to 8 million individuals with tele health benefts paid for by their employer. Companies such as Accenture,Te Home Depot, Amazon, Metro PCS, AT&T, Penske, CalPERS and some insurance companies have been ofering telehealth. Why is telehealth gaining so momen tum? It addresses the three biggest issues in healthcare today: • Timely Access • Lower Costs • Quality Care Te established telehealth providers ofer access to experienced, licensed, board certifed physicians 24 hours a day, seven days a week. If individuals have a minor illness, they can talk to a doctor by phone or online, receive a diagnosis and treatment, including a prescription if needed, all within an hour. Minor health illnesses include: • Sinusitis • Cold • Flu • Headache • Stomach ache • Respiratory infection • Urinary tract infection • Pink eye • Ear infection • Cough • Allergy Te doctors from the established tele health frms typically derive from primary care, internal medicine, emergency room or pediatric practices, with an average of 15 years experience.Tey have been thoroughly vetted and have undergone extensive peer reviews and the full creden tialing process. Most of them are practicing physicians, like your own family doctor, and dedicate extra time for these consultations. Some programs ofer more expanded services, such as access to specialists who respond to medical questions via email, ofen sending links to articles and videos designed to educate consumers and help them manage their health. It is essential to understand that tele health is not meant to replace primary care physicians. In fact, telehealth doctors encourage patients to see their doctor and get their wellness exams and lab work completed.Tey can even send their tel ephonic or online consult records directly to the patient’s physician.Tey simply provide an efcient and cost efective solution for those with minor health conditions who can’t get to a doctor in a timely manner. It’s a win for all. Individuals save time and money. Employers can see tremen dous reductions in absenteeism, leading to increased productivity. Self funded
  2. 2. companies can see immediate savings to their bottom line. According to Absenteeism:Te Bottom Line Killer, a publication of workforce solution company Circadian, unscheduled absenteeism costs roughly $3,600 per year for each hourly worker and $2,650 each year for salaried employees. Te Gallup HealthwaysWell Being Index surveyed 94,000 workers across 14 major occupations in the U.S. Of the 77% of workers who ft the survey’s defnition of having a chronic health condition (asthma, cancer, depression, diabetes, heart attack, high blood pressure, high cholesterol or obesity), the total annual costs related to lost productivity totaled $84 billion.3 Typical results from a prominent tele health frm from 2013 showed the following: • 125,000 medical consults • 91% of patient issues resolved • 97% member satisfaction rating • Average wait time: 24 minutes • Redirection of care: • 43% would have gone to doctor • 34% would have used an urgent care clinic • 8% would have visited the ER When factoring in the costs saved by redirecting care and keeping the employee at work, our calculations show that each call to a telehealth doctor will save an employer close to $240.4 When you look at the math, the num bers are staggering. If it’s really that efective, some people may inquire:Ten why isn’t everyone using telehealth as part of their cost containment strategy? It’s a good question. Te answer is quite simple:Te potential for these results is clearly evident, but the actual results are based on utilization, which has garnered lower results. Tere are several reasons utilization has not met expectations.Te frst is that most 50 HIU | telehealth providers sell “access” to their service at a low fee and then charge $35 $40 to the employee for the medical consult. Te problem here is telehealth is still a new technology and employees seem reluctant to pay for a phone consult when they don’t quite understand the beneft. Tis brings up the other problem, which is educating the employee about telehealth what is it and how to use it. In years to come, as telehealth becomes as mainstream as social media, individuals may not mind paying $35 or more to get immediate access to a doctor by phone, es pecially if they have a high deductible plan and/or don’t have the time to visit a doctor. But, today, that isn’t the case. Telehealth is still relatively unknown to most individu als, not to mention to most employers. What is needed today to make a tele health beneft a success story is simple. It’s the same thing all corporate wellness directors have attempted for the last 25 years. It’s all about changing behavior. It is far more difcult to change be havior when trying to get employees to change their diets and go to the gym. It isn’t so difcult to change behavior when introducing a telehealth beneft. • Te frst thing to do is change the busi ness model. Build the doctor’s fee in to the monthly cost of the program so employees don’t have to pay anything to call a doctor. Eliminate the barrier.What do they have to lose? • Create an awareness building campaign that includes regular monthly remind ers what is telehealth, when should it be used, what conditions can it treat, how to access a doctor, seasonal reminders/tips for fu season, allergy season, summer vacations, etc.Tose who hear about it during open enrollment without any follow up have long forgotten they even have the beneft by the time they need it several months later. It has to be the frst thing they think about when they get sick. • Encourage employees to share their experiences with telehealth via internal communication materials.Te more peo ple who use it, the more they understand the efciency and low cost, the more likely they are to talk about the benefts and remind others of the program. It is simple for the service to gain traction in the workplace by word of mouth. Healthcare has changed and will con tinue to do so. Companies will continue to grapple with the question of what is best for the company and what is best for the employee. Self funded companies will look for innovative solutions that can have an immediate and long term impact. For fully insured companies, there will be changes that will result in higher deduct ibles and many that result in employees being told to select their own health plans. In all cases, telehealth is a solution. Im mediate access to care by phone or online saves time and money and allows those who need care the most to get in to see a doctor. Individuals can easily save hun dreds, if not thousands, of dollars a year in out of pocket costs. Companies cannot only manage healthcare costs far better, but they can also decrease absenteeism and increase productivity a goal they have been working on for the last 30 years. It’s not the future. It’s here today. HIU 1 Schultz, R. (2012, January 09). New medical cost savings program: Telemedicine means great discounts. 2 Employers Plan Aggressive Response to Shifing Health Care Landscape, TowersWatson/Na tional Business Group on Health Survey Finds. (2013, March 07). 3 Te Causes and Costs of Absenteeism in the Workplace. (2013, July 10). 4 Based on the following assumptions: PCP visit $122, urgent care visit $152, ER visit $752, time missed from work four hours @ $21.74 per hour. TELEHEALTH